Nasal provocative test in patients allergic to pollen

• Published in: Annals of Agricultural and Environmental Medicine 2005, Vol.12 (2), p.173-176
• Main Authors: Wojdas, Andrzej, Rapiejko, Piotr, Zielnik-Jurkiewicz, Beata, Kantor, Ireneusz
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Allergens; Allergens - administration & dosage; Allergies; Antigens; Female; Grasses; Humans; Immunoglobulin E; Inflammation; Male; Mucosa; Nasal Mucosa - immunology; Nasal Mucosa - secretion; Nasal Provocation Tests - methods; Patients; Plant Proteins - immunology; Poaceae; Pollen; Pollen - immunology; Pollinosis; Predictive Value of Tests; Research methods; Respiratory tract; Rhinitis, Allergic, Seasonal - diagnosis; Rhinitis, Allergic, Seasonal - immunology; Rhinitis, Allergic, Seasonal - therapy; Sensitivity analysis
• ISSN: 1232-1966; 1898-2263

Nasal provocative test (NPT) can be defined as a method for recreating upper respiratory tract response to natural allergens or irritants. It can be used in solving nasal patophisiology problems: establishing whether and how the patient's nose is sensitive to antigens or irritants; quantitative evaluation of sensitivity; establishing factors influencing sensitivity. This method is employed to confirm clinical diagnosis in cases where difficulties arise in interpretation of diagnostic tests. The study based on nasal provocative tests establish an allergy to pollen in cases of pollinosis, and select appropriate components for the desensitising vaccine. Sample group included 53 patients, 29 were females and 24 were males, aged 15-42 years, selected from 1,021 patients diagnosed between 1999-2002 in the Allergology Department of the ENT Department of the MMI. The sample patients were diagnosed based on additional tests with allergic inflammation of the nasal mucosa caused by allergy to pollen of such plants as birch, grass, rye, mugwort and plantain. Research methods included: subjective physical examination, prick tests, total and specific IgE levels in serum, nasal provocative tests and rhinomanometric examination. Allergen solution was administered onto the mucosa with a calibrated atomiser. NPT solutions containing pollen of birch, grass, rye, mugwort and plantain were used. Provocative test was considered positive if, following allergen provocation, rhinomanometric examination revealed an increase in respiratory resistance by at least 40 % in comparison with the control test. On the basis of the study, 2 conclusions were drawn: 1) Nasal provocative test is an essential element in diagnostics of allergic nasal obstruction. 2) Rhinomanometry, as an objective method of examining nasal patency, is crucial for evaluating the nasal provocative test.